Study: Early diagnosis critical for psoriatic arthritis

By Melissa Leavitt

People with psoriasis should report symptoms of psoriatic arthritis to their doctor as soon as possible, according to findings from a recent study. Even waiting as long as six months can lead to significantly more joint and bone damage and worse physical disability, the researchers note.

The study, "Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis," was published in the February issue of the Annals of the Rheumatic Diseases.

Researchers assessed the symptoms of 283 patients with psoriatic arthritis, analyzing the relationship between disease severity and diagnostic delay, or the amount of time before patients were diagnosed with psoriatic arthritis.

Only 30 percent of patients were diagnosed within six months of the onset of symptoms, while approximately 70 percent had up to a two-year delay in diagnosis.

Patients with a diagnostic delay of more than six months had worse clinical outcomes, researchers found. On top of experiencing worse bone and joint deterioration, these patients also responded less successfully to treatment.

A diagnostic delay of more than a year significantly reduced a patient's chance of achieving complete drug-free remission of the disease, as compared with patients who waited less than six months.

"Early diagnosis and management is vital for good long-term outcomes, not only for structural joint damage but also on quality of life and long-term physical function," said Dr. Muhammad Haroon, the lead author of the study.

The study was conducted in Ireland, where people see a general practitioner before being referred to a specialist. Researchers consulted general practitioner records to determine when the patient's symptoms first appeared, and measured the diagnostic delay as the amount of time the patient waited before following up with a rheumatologist. The study did not focus on the role of physicians in contributing to diagnostic delay.

In a previous study, Haroon found that nearly 30 percent of psoriasis patients who saw a dermatologist also had undiagnosed psoriatic arthritis. Patient education is key to making sure that people with psoriatic arthritis are diagnosed and treated as soon as possible, said Haroon.

"Every psoriasis patient should be carefully evaluated for psoriatic arthritis," he said.